Aetna, Memorial Hermann ACO: A Year in the Making

Moving past hurdles, building trust
Lloyd and Holmes both say that initially the two organizations struggled to trust that they were on the same page. One hurdle was laying aside the memories of attempts to change healthcare in the 1990s, which left organizations wary of sharing risk.

"Those early meetings were sort of the traditional looking-across-the-table-at-your-foe and you're trying to see what you can get for both your interests," says Holmes. "And it took a little while before we both began to say, 'Okay, we have to trust one another; we have to share information at a level we've not done before.' That transparency, I think created some trust."

Holmes also calls the level of transparency between Aetna and MHMD "unprecedented." Sharing data is part of a long list of other shared responsibilities, but it is crucial to maintaining the trust the two have established. It also plays an important role in figuring out best practices with a relatively new model of care.